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Against
from Section II - IVF Add-ons
Published online by Cambridge University Press: 25 November 2021
DHEA is a pro hormone produced by the adrenal gland and is a precursor to testosterone and consequently oestrogen production by the ovary. Its use in women with anticipated poor response to IVF has been suggested for some time. The concept behind its use is the potential improvement in follicle sensitivity to FSH through an increase in local androgen production within the ovary. There is also a suggestion that DHEA can improve abnormal mitochondrial dynamics within the cumulus cells in women with poor ovarian response [1]. As attractive as these concepts may be, the use of DHEA in women with potential poor response is supported by very little clinical evidence, and consequently its usage seems to stem from a desperation within the clinical community, given the very few options available in this group of women. The majority of studies in the literature are either retrospective or involve a small group of participants. They are also underpowered and associated with significant heterogeneity, with different definitions of poor ovarian reserve used amongst studies.
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